tbuckley/cabot-search huggingface dataset:
Association of Women Surgeons’ Comprehensive Initiative for Healthy Surgical Families During Residency and Fellowship Training
Authors: Helen M. Johnson, Madeline B. Torres, Mecker G. Möller, Lisa Cannada, Lauren B. Nosanov, Andrea N. Riner, Leah C. Tatebe, Chantal Reyna, Maria S. Altieri
Journal: JAMA Surgery (2023)

The lack of family-friendly policies continues to contribute to the underrepresentation and attrition of surgical trainees. Women in surgery face unique challenges in balancing surgical education with personal and family needs.The Association of Women Surgeons is committed to supporting surgical families and developing equitable family-friendly guidelines. Herein we detail recommendations for adequate paid parental leave, access to childcare, breastfeeding support, and insurance coverage of fertility preservation and assisted reproductive technology.The specific recommendations outlined in this document form the basis of a comprehensive initiative for supporting surgical families.
Mistreatment and Wellness Among International Medical Graduates in US General Surgical Residency
Authors: Jennifer Delgado Felipa, Andrew Hu, Joshua Eng, Hasan B. Alam, June M. McKoy, Karl Y. Bilimoria, Yue-Yung Hu
Journal: JAMA Surgery (2023)

This study uses data from a cross-sectional national survey of medical residents in the US to assess whether mistreatment experiences and wellness differ between international medical graduates and US medical graduates.
Comparison of Opioids Prescribed by Advanced Practice Clinicians vs Surgeons After Surgical Procedures in the US
Authors: Caitlin R. Priest, Jennifer F. Waljee, Mark C. Bicket, Hsou-Mei Hu, Kao-Ping Chua
Journal: JAMA Network Open (2023)

Importance Advanced practice clinicians (APCs), defined as nurse practitioners and physician assistants, are increasingly being incorporated into surgical teams. Despite this inclusion, there are no recent national data on the role of these clinicians in surgical opioid prescribing or the dosing of such prescriptions. Objective To calculate the proportion of surgical opioid prescriptions written by APCs and to compare the total and daily dosages of these prescriptions with those written by surgeons. Design, Setting, and Participants This cross-sectional study used the Optum’s De-Identified Clinformatics Data Mart, which contains deidentified claims from patients with private insurance and Medicare Advantage plans across the US. Adults and children who underwent 1 of 31 inpatient and outpatient surgical procedures from January 1, 2017, through November 30, 2019, were identified. The analysis was limited to procedures with 1 or more perioperative opioid prescriptions, defined as an opioid prescription dispensed within 3 days of the index date of surgery. Data were analyzed from April 1, 2021, to July 31, 2022. Exposures Prescriber specialty. Main Outcomes and Measures The outcome was the proportion of perioperative opioid prescriptions and refill prescriptions written by APCs. Linear regression was used to compare the total dosage of perioperative opioid prescriptions written by APCs vs surgeons measured in morphine milligram equivalents (MMEs). Models were adjusted for demographic characteristics, comorbidities, opioid-naive status, year of index date, hospitalization or observation status, surgical complications, and surgeon specialty. Analyses were conducted at the procedure level, and patients with multiple procedures were included. Results Analyses included 628 197 procedures for 581 387 patients (358 541 females [57.1%]; mean [SD] age, 56 [18] years). Overall, APCs wrote 119 266 (19.0%) of the 628 197 perioperative opioid prescriptions and 59 679 (25.1%) of the 237 740 refill prescriptions. Perioperative opioid prescriptions written by APCs had higher total dosages compared with those written by surgeons (adjusted difference, 40.0 MMEs; 95% CI, 31.3-48.7 MMEs). This difference persisted in a subgroup analysis limited to opioid-naïve patients (adjusted difference, 15.7 MMEs; 95% CI, 13.9-17.5 MMEs). Conclusions and Relevance In this cross-sectional analysis, one-fifth of perioperative opioid prescriptions and one-quarter of refill prescriptions were written by APCs. While surgeons wrote most perioperative opioid prescriptions that were intended for perioperative analgesia, higher total dosages from APCs suggest that opioid stewardship initiatives that support the role of APCs may be warranted.
Treatment of Trichilemmomas With Topical Sirolimus
Authors: Anisha Bhanot, Katelin Harrell, Jarad Levin
Journal: JAMA Dermatology (2023)

This case report describes a woman in her 60s flesh-colored papules that were localized to the central face and a lobular downgrowth of cells with clear, expanded, faintly glassy cytoplasm.
Association Between Hydrological Conditions and Dengue Fever Incidence in Coastal Southeastern China From 2013 to 2019
Authors: Chuanxi Li, Zhendong Wang, Yu Yan, Yinan Qu, Liangyu Hou, Yijie Li, Cordia Chu, Alistair Woodward, Tamara Schikowski, Paulo Hilário Nascimento Saldiva, Qiyong Liu, Qi Zhao, Wei Ma
Journal: JAMA Network Open (2023)

Importance Dengue fever is a climate-sensitive infectious disease. However, its association with local hydrological conditions and the role of city development remain unclear. Objective To quantify the association between hydrological conditions and dengue fever incidence in China and to explore the modification role of city development in this association. Design, Setting, and Participants This cross-sectional study collected data between January 1, 2013, and December 31, 2019, from 54 cities in 4 coastal provinces in southeast China. The Standardized Precipitation Evapotranspiration Index (SPEI) was calculated from ambient temperature and precipitation, with SPEI thresholds of 2 for extreme wet conditions and −2 for extreme dry conditions. The SPEI–dengue fever incidence association was examined over a 6-month lag, and the modification roles of 5 city development dimensions were assessed. Data were analyzed in May 2022. Exposures City-level monthly temperature, precipitation, SPEI, and annual city development indicators from 2013 to 2019. Main Outcomes and Measures The primary outcome was city-level monthly dengue fever incidence. Spatiotemporal bayesian hierarchal models were used to examine the SPEI–dengue fever incidence association over a 6-month lag period. An interaction term between SPEI and each city development indicator was added into the model to assess the modification role of city development. Results Included in the analysis were 70 006 dengue fever cases reported in 54 cities in 4 provinces in China from 2013 to 2019. Overall, a U-shaped cumulative curve was observed, with wet and dry conditions both associated with increased dengue fever risk. The relative risk [RR] peaked at a 1-month lag for extreme wet conditions (1.27; 95% credible interval [CrI], 1.05-1.53) and at a 6-month lag for extreme dry conditions (1.63; 95% CrI, 1.29-2.05). The RRs of extreme wet and dry conditions were greater in areas with limited economic development, health care resources, and income per capita. Extreme dry conditions were higher and prolonged in areas with more green space per capita (RR, 1.84; 95% CrI, 1.37-2.46). Highly urbanized areas had a higher risk of dengue fever after extreme wet conditions (RR, 1.80; 95% CrI, 1.26-2.56), while less urbanized areas had the highest risk of dengue fever in extreme dry conditions (RR, 1.70; 95% CrI, 1.11-2.60). Conclusions and Relevance Results of this study showed that extreme hydrological conditions were associated with increased dengue fever incidence within a 6-month lag period, with different dimensions of city development playing various modification roles in this association. These findings may help in developing climate change adaptation strategies and public health interventions against dengue fever.
Frailty and Effects of a Multidomain Physical Rehabilitation Intervention Among Older Patients Hospitalized for Acute Heart Failure
Authors: Ambarish Pandey, Dalane W. Kitzman, M. Benjamin Nelson, Amy M. Pastva, Pamela Duncan, David J. Whellan, Robert J. Mentz, Haiying Chen, Bharathi Upadhya, Gordon R. Reeves
Journal: JAMA Cardiology (2023)

Frailty is common among older patients with acute decompensated heart failure (ADHF) and is associated with worse quality of life (QOL) and a higher risk of clinical events. Frailty can also limit recovery and response to interventions. In the Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial, a 3-month innovative, early, transitional, tailored, multidomain physical rehabilitation intervention improved physical function and QOL (vs usual care) in older patients with ADHF.
Associations Between Procrastination and Subsequent Health Outcomes Among University Students in Sweden
Authors: Fred Johansson, Alexander Rozental, Klara Edlund, Pierre Côté, Tobias Sundberg, Clara Onell, Ann Rudman, Eva Skillgate
Journal: JAMA Network Open (2023)

Importance Procrastination is prevalent among university students and is hypothesized to lead to adverse health outcomes. Previous cross-sectional research suggests that procrastination is associated with mental and physical health outcomes, but longitudinal evidence is currently scarce. Objective To evaluate the association between procrastination and subsequent health outcomes among university students in Sweden. Design, Setting, and Participants This cohort study was based on the Sustainable University Life study, conducted between August 19, 2019, and December 15, 2021, in which university students recruited from 8 universities in the greater Stockholm area and Örebro were followed up at 5 time points over 1 year. The present study used data on 3525 students from 3 time points to assess whether procrastination was associated with worse health outcomes 9 months later. Exposure Self-reported procrastination, measured using 5 items from the Swedish version of the Pure Procrastination Scale rated on a Likert scale from 1 (“very rarely or does not represent me”) to 5 (“very often or always represents me”) and summed to give a total procrastination score ranging from 5 to 25. Main Outcomes and Measures Sixteen self-reported health outcomes were assessed at the 9-month follow-up. These included mental health problems (symptoms of depression, anxiety, and stress), disabling pain (neck and/or upper back, lower back, upper extremities, and lower extremities), unhealthy lifestyle behaviors (poor sleep quality, physical inactivity, tobacco use, cannabis use, alcohol use, and breakfast skipping), psychosocial health factors (loneliness and economic difficulties), and general health. Results The study included 3525 participants (2229 women [63%]; mean [SD] age, 24.8 [6.2] years), with a follow-up rate of 73% (n = 2587) 9 months later. The mean (SD) procrastination score at baseline was 12.9 (5.4). An increase of 1 SD in procrastination was associated with higher mean symptom levels of depression (β, 0.13; 95% CI, 0.09-0.17), anxiety (β, 0.08; 95% CI, 0.04-0.12), and stress (β, 0.11; 95% CI, 0.08-0.15), and having disabling pain in the upper extremities (risk ratio [RR], 1.27; 95% CI, 1.14-1.42), poor sleep quality (RR, 1.09, 95% CI, 1.05-1.14), physical inactivity (RR, 1.07; 95% CI, 1.04-1.11), loneliness (RR, 1.07; 95% CI, 1.02-1.12), and economic difficulties (RR, 1.15, 95% CI, 1.02-1.30) at the 9-month follow-up, after controlling for a large set of potential confounders. Conclusions and Relevance This cohort study of Swedish university students suggests that procrastination is associated with subsequent mental health problems, disabling pain, unhealthy lifestyle behaviors, and worse psychosocial health factors. Considering that procrastination is prevalent among university students, these findings may be of importance to enhance the understanding of students’ health.
Cost-effectiveness of Fibrinogen Concentrate vs Cryoprecipitate for Treating Acquired Hypofibrinogenemia in Bleeding Adult Cardiac Surgical Patients
Authors: Lusine Abrahamyan, George Tomlinson, Jeannie Callum, Steven Carcone, Deep Grewal, Justyna Bartoszko, Murray Krahn, Keyvan Karkouti
Journal: JAMA Surgery (2023)

Excessive bleeding requiring fibrinogen replacement is a serious complication of cardiac surgery. However, the relative cost-effectiveness of the 2 available therapies-fibrinogen concentrate and cryoprecipitate-is unknown.To determine cost-effectiveness of fibrinogen concentrate vs cryoprecipitate for managing active bleeding in adult patients who underwent cardiac surgery.A within-trial economic evaluation of the Fibrinogen Replenishment in Surgery (FIBERS) randomized clinical trial (February 2017 to November 2018) that took place at 4 hospitals based in Ontario, Canada, hospitals examined all in-hospital resource utilization costs and allogeneic blood product (ABP) transfusion costs incurred within 28 days of surgery. Participants included a subset of 495 adult patients from the FIBERS trial who underwent cardiac surgery and developed active bleeding and acquired hypofibrinogenemia requiring fibrinogen replacement.Fibrinogen concentrate (4 g per dose) or cryoprecipitate (10 units per dose) randomized (1:1) up to 24 hours postcardiopulmonary bypass.Effectiveness outcomes included number of ABPs administered within 24 hours and 7 days of cardiopulmonary bypass. ABP transfusion (7-day) and in-hospital resource utilization (28-day) costs were evaluated and a multivariable net benefit regression model built for the full sample and predefined subgroups.Patient level costs for 495 patients were evaluated (mean [SD] age 59.2 [15.4] years and 69.3% male.) Consistent with FIBERS, ABP transfusions and adverse events were similar in both treatment groups. Median (IQR) total 7-day ABP cost was CAD $2280 (US dollars [USD] $1697) (CAD $930 [USD $692]-CAD $4970 [USD $3701]) in the fibrinogen concentrate group and CAD $2770 (USD $1690) (IQR, CAD $1140 [USD $849]-CAD $5000 [USD $3723]) in the cryoprecipitate group. Median (interquartile range) total 28-day cost was CAD $38 180 (USD $28 431) $(IQR, CAD $26 350 [USD $19 622]-CAD $65 080 [USD $48 463]) in the fibrinogen concentrate group and CAD $38 790 (USD $28 886) (IQR, CAD $26 180 [USD $19 495]-CAD $70 380 [USD $52 409]) in the cryoprecipitate group. After exclusion of patients who were critically ill before surgery (11%) due to substantial variability in costs, the incremental net benefit of fibrinogen concentrate vs cryoprecipitate was positive (probability of being cost-effective 86% and 97% at $0 and CAD $2000 (USD $1489) willingness-to-pay, respectively). Net benefit was highly uncertain for nonelective and patients with critical illness.Fibrinogen concentrate is cost-effective when compared with cryoprecipitate in most bleeding adult patients who underwent cardiac surgery with acquired hypofibrinogenemia requiring fibrinogen replacement. The generalizability of these findings outside the Canadian health system needs to be verified.
One Beat Is All It Takes—Wide Complex Tachycardia in a Middle-aged Man
Authors: Samuel Sauerwein, Jenna Spears, Gan-Xin Yan
Journal: JAMA Cardiology (2023)

A man in his mid-50s with a medical history of nonspecific T-wave abnormalities on electrocardiogram reported new-onset chest discomfort, diaphoresis, and shortness of breath that woke him from sleep. Emergency medical services found him to be in a wide complex tachycardia. What would you do next?
Effect of Technology-Enhanced Screening in Addition to Standard Targeted Clinician Education on the Duration of Untreated Psychosis
Authors: Tara A. Niendam, Rachel Loewy, Mark Savill, Kevin L. Delucchi, Tyler A. Lesh, J. Daniel Ragland, Khalima Bolden, Haley V. Skymba, Sarah Gobrial, Monet S. Meyer, Katherine M. Pierce, Adi Rosenthal, Taylor L. Fedechko, Laura M. Tully, Valerie L. Tryon, Howard Goldman, Rosemary D. Cress, Richard L. Kravitz, Cameron S. Carter
Journal: JAMA Psychiatry (2023)

Reducing the duration of untreated psychosis (DUP) is essential to improving outcomes for people with first-episode psychosis (FEP). Current US approaches are insufficient to reduce DUP to international standards of less than 90 days.
Simplified Meal Announcement Versus Precise Carbohydrate Counting in Adolescents With Type 1 Diabetes Using the MiniMed 780G Advanced Hybrid Closed Loop System: A Randomized Controlled Trial Comparing Glucose Control
Authors: Goran Petrovski, Judith Campbell, Maheen Pasha, Emma Day, Khalid Hussain, Amel Khalifa, Tim van den Heuvel
Journal: Diabetes Care (2023)

OBJECTIVE We aimed to compare glucose control in adolescents with type 1 diabetes (T1D) using the MiniMed 780G system who used simplified meal announcement with those who used precise carbohydrate counting. RESEARCH DESIGN AND METHODS This randomized controlled trial included 34 participants (age 12–18 years) with T1D who were on multiple daily injections or insulin pump and were scheduled to start using the MiniMed 780G system at Sidra Medicine in Qatar. After a 7-day run-in period, participants were randomly assigned to the fix group (simplified meal announcement by preset of three personalized fixed carbohydrate amounts) or the flex group (precise carbohydrate counting) and followed for 12 weeks. Between-group difference in time in range (TIR) was the primary end point. Secondary end points included HbA1c and other glycometrics. RESULTS During the 12-week study phase, TIR was 73.5 ± 6.7% in the fix and 80.3 ± 7.4% in the flex group, with a between-group difference of 6.8% in favor of flex (P = 0.043). Time &amp;gt;250 mg/dL was better in the flex group (P = 0.012), whereas HbA1c (P = 0.168), time below range (P = 0.283), and time between 180 and 250 mg/dL (P = 0.114) did not differ. CONCLUSIONS Adolescents using the MiniMed 780G system with a preset of three personalized fixed carbohydrate amounts can reach international targets of glycemic control. Therefore, it may be a valuable alternative to precise carbohydrate counting in users who are challenged by precise carbohydrate counting. Because carbohydrate counting further improves outcomes, these skills remain important for MiniMed 780G users.
Diagnostic accuracy of FibroScan-AST (FAST) score for the non-invasive identification of patients with fibrotic non-alcoholic steatohepatitis: a systematic review and meta-analysis
Authors: Federico Ravaioli, Elton Dajti, Alessandro Mantovani, Philip Noel Newsome, Giovanni Targher, Antonio Colecchia
Journal: Gut (2023)

Objective A simple combined score with liver stiffness, controlled attenuation parameter and serum aspartate aminotransferase (AST), the FibroScan-AST (FAST) score, has been proposed to non-invasively identify patients with fibrotic non-alcoholic steatohepatitis (NASH). We performed a systematic review and meta-analysis of published studies to evaluate the overall diagnostic accuracy of the FAST score in identifying patients with fibrotic NASH. Design We systematically searched MEDLINE, Ovid Embase, Scopus and Cochrane Library electronic databases for full-text published articles in any language between 3 February 2020 and 30 April 2022. We included original articles that reported data for the calculation of sensitivity and specificity of the FAST score for identifying adult patients with fibrotic NASH adults, according to previously described rule-out (≤0.35) and rule-in (≥0.67) cut-offs. Results We included 12 observational studies for a total of 5835 participants with biopsy-confirmed non-alcoholic fatty liver disease. The pooled prevalence of fibrotic NASH was 28% (95% CI 21% to 34%). The FAST score’s pooled sensitivity was 89% (95% CI 82% to 93%), and the pooled specificity was 89% (95% CI 83% to 94%) according to the aforementioned rule-in/rule-out cut-offs. The negative predictive value and positive predictive value of the FAST score were 92% (95% CI 91% to 95%) and 65% (95% CI 53% to 68%), respectively. Subgroup analyses and influential bias analyses did not alter these findings. Conclusion The results of our meta-analysis show that the FAST score has a good performance for non-invasive diagnosis of fibrotic NASH. Therefore, this score can be used to efficiently identify patients who should be referred for a conclusive liver biopsy and/or consideration for treatment with emerging pharmacotherapies. PROSPERO registration number CRD42022350945.
Endemic rise in cases of acute kidney injury in children in Indonesia and Gambia: what is the likely culprit and why?
Authors: Tungki Pratama Umar, Nityanand Jain, Henri Azis
Journal: Kidney International (2023)

A sudden rise in the cases of acute kidney injury (AKI) has been reported in Indonesia and Gambia that has been linked to the consumption of tainted syrup medications for cough, colds, pain, and fever. Preliminary investigations revealed multiple lapses in quality control during manufacturing including substitution of diethylene glycol (DEG) and ethylene glycol (EG) for the more expensive but non-toxic solvent glycerol. In this editorial report, we shed light upon the current situation and urge the investigating authorities to make those responsible accountable to regain public trust.
Genetic Regulation of SMC Gene Expression and Splicing Predict Causal CAD Genes
Authors: Rédouane Aherrahrou, Dillon Lue, R. Noah Perry, Yonathan Tamrat Aberra, Mohammad Daud Khan, Joon Yuhl Soh, Tiit Örd, Prosanta Singha, Qianyi Yang, Huda Gilani, Ernest Diez Benavente, Doris Wong, Jameson Hinkle, Lijiang Ma, Gloria M. Sheynkman, Hester M. den Ruijter, Clint L. Miller, Johan L.M. Björkegren, Minna U. Kaikkonen, Mete Civelek
Journal: Circulation Research (2023)

Coronary artery disease (CAD) is the leading cause of death worldwide. Recent meta-analyses of genome-wide association studies have identified over 175 loci associated with CAD. The majority of these loci are in noncoding regions and are predicted to regulate gene expression. Given that vascular smooth muscle cells (SMCs) play critical roles in the development and progression of CAD, we aimed to identify the subset of the CAD loci associated with the regulation of transcription in distinct SMC phenotypes.
Errors in Funding/Support
Authors: Salam Abdus, Thomas Selden
Journal: JAMA Pediatrics (2023)

Cindy T. McEvoy, MD, MCR; Lyndsey E. Shorey-Kendrick, PhD; Kristin Milner, BA; Julia Harris, BS; Brittany Vuylsteke, MPH; Michelle Cunningham, RRT; Christina Tiller, RRT; Jaclene Stewart, BS; Diane Schilling, RRT; Julie Brownsberger, BA; Hope Titus, BS; Kelvin D. MacDonald, MD, RRT; David Gonzales, PhD; Annette Vu, MPH; Byung S. Park, PhD; Eliot R. Spindel, MD, PhD; Cynthia D. Morris, PhD, MPH; Robert S. Tepper, MD, PhD
Bridging strategies and cardiac replacement outcomes in patients with acute decompensated heart failure‐related cardiogenic shock
Authors: Anubodh S. Varshney, David D. Berg, Guohai Zhou, Lauren Sinnenberg, Sameer Hirji, Ersilia M. DeFilippis, Hari R. Mallidi, David A. Morrow, Daniel Rinewalt, Michael M. Givertz
Journal: European Journal of Heart Failure (2023)
Type I interferon signaling facilitates resolution of acute liver injury by priming macrophage polarization
Authors: Qiaoling Song, Shyamasree Datta, Xue Liang, Xiaohan Xu, Paul Pavicic, Xiaonan Zhang, Yuanyuan Zhao, Shan Liu, Jun Zhao, Yuting Xu, Jing Xu, Lihong Wu, Zhihua Wu, Minghui Zhang, Zhan Zhao, Chunhua Lin, Yuxin Wang, Peng Han, Peng Jiang, Yating Qin, Wei Li, Yingying Zhang, Yonglun Luo, Ganes Sen, George R. Stark, Chenyang Zhao, Thomas Hamilton, Jinbo Yang
Journal: Cellular and Molecular Immunology (2023)